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Bones of the Upper Limb: Ulna01:15

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A classification system for ulnar polydactyly and clinical series.

Alpay Duran1, Nesibe Sinem Ciloglu1, Hasan Buyukdogan1

  • 1Department of Plastic, Reconstructive, and Aesthetic Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.

The Journal of Hand Surgery
|February 25, 2015
PubMed
Summary

A modified classification for ulnar polydactyly is proposed, encompassing complicated and bifid proximal phalanx types. This new system aims to improve diagnosis and treatment planning for these specific ulnar polydactyly presentations.

Keywords:
Ulnar polydactylybifid proximal phalanxclassificationpolysyndactylytriplication

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Area of Science:

  • Orthopedic surgery
  • Congenital hand anomalies
  • Pediatric orthopedics

Background:

  • Ulnar polydactyly is a common congenital hand anomaly.
  • Existing classification systems do not adequately address complicated ulnar polydactyly or ulnar polydactyly with bifid proximal phalanx.
  • Accurate classification is crucial for effective surgical management.

Purpose of the Study:

  • To introduce a modified classification system for ulnar polydactyly.
  • This system integrates both complicated ulnar polydactyly and ulnar polydactyly with bifid or duplicated proximal phalanx.
  • To apply this novel classification to a clinical series of patients.

Main Methods:

  • Retrospective analysis of clinical and radiological data from 42 patients with ulnar polydactyly.
  • Patients were seen between January 2004 and January 2014.
  • Data were organized into 5 distinct subgroups based on morphology and duplication characteristics.

Main Results:

  • The study included 42 patients (20 bilateral, 22 unilateral).
  • Supernumerary digits were classified into types I-V.
  • Nine patients presented with bifid or duplicated proximal phalanges (types IIIA and IIIB), and 2 with complicated ulnar polydactyly (type V).

Conclusions:

  • Complicated ulnar polydactyly and ulnar polydactyly with bifid proximal phalanx are distinct entities with significant surgical implications.
  • Current classification systems (Pritsch, Rayan, Al-Qattan) do not encompass both types simultaneously.
  • The proposed modified classification aims to enhance diagnostic accuracy and guide treatment strategies for these specific ulnar polydactyly variations.